Ancel Pierre-Yves, Marret Stéphane, Larroque Béatrice, Arnaud Catherine, Zupan-Simunek Véronique, Voyer Marcel, Rozé Jean-Christophe, Matis Jacqueline, Burguet Antoine, Ledésert Bernard, André Monique, Pierrat Véronique, Kaminski Monique
Inserm U149 Research Unit on Perinatal Health and Women's Health, Villejuif, France.
Am J Obstet Gynecol. 2005 Jul;193(1):178-84. doi: 10.1016/j.ajog.2004.11.057.
The purpose of this study was to examine the relationships between different causes of preterm delivery (eg, maternal hypertension, small-for-gestational age [SGA], other) and cerebral damage (eg, cystic periventricular leukomalacia [c-PVL], grade III intraventricular hemorrhage [IVH], and intra-parenchymal hemorrhage [IPH]).
This study included 1902 very preterm singletons who were transferred to neonatal intensive care units in 9 French regions. We used logistic regression models to compare the risk of cerebral injury associated with maternal hypertension, SGA, and all other causes of preterm delivery.
We found that the risk of c-PVL and grade III IVH was higher in infants born after preterm premature rupture of membranes (PPROM) with short latency or idiopathic preterm labor than in infants born to hypertensive mothers. We show that SGA and antepartum maternal hemorrhage significantly increase the risk of IPH.
Our results show that infants born to hypertensive mothers have a lower risk of cerebral injuries than infants born following idiopathic preterm labor and PPROM because they are less exposed to prenatal infection.
本研究旨在探讨早产的不同原因（如母亲高血压、小于胎龄儿[SGA]、其他原因）与脑损伤（如脑室周围白质软化症[c-PVL]、III级脑室内出血[IVH]和脑实质内出血[IPH]）之间的关系。
本研究纳入了法国9个地区转至新生儿重症监护病房的1902例极早早产单胎婴儿。我们使用逻辑回归模型比较与母亲高血压、小于胎龄儿以及早产的所有其他原因相关的脑损伤风险。
我们发现，胎膜早破早产（PPROM）且潜伏期短或特发性早产的婴儿发生c-PVL和III级IVH的风险高于高血压母亲所生婴儿。我们表明，小于胎龄儿和产前母亲出血会显著增加IPH的风险。
我们的结果表明，高血压母亲所生婴儿发生脑损伤的风险低于特发性早产和PPROM后出生的婴儿，因为他们较少暴露于产前感染。
